Free GP care?

gaffer91

About a month ago, the government announced plans to introduce free GP care for all by 2015. Having done a search and not seen any threads on this in Politics (there was one in AH), I'm interested to hear what people's thoughts on it are?

Personally I think it is a bad idea. At a cost of €300 million per year I'm not sure it represents value for money. While I am not opposed at all to giving medical cards to people who genuinely can't afford GP care, I think giving freebies to people who clearly can pay is almost always bad economics (one only has to look at the drain of child benefit to families who don't need it).

Also it is quite easy to envisage a future where there is a massive "clogging up" in primary care as people abuse their new free privilege, which will lead to a massively reduced quality of service. This will also have knock on effects for the entire health service.

Thoughts?

Link- http://www.irishtimes.com/newspaper/ireland/2011/1118/1224307766698.html

Good loser

gaffer91 wrote: »

About a month ago, the government announced plans to introduce free GP care for all by 2015. Having done a search and not seen any threads on this in Politics (there was one in AH), I'm interested to hear what people's thoughts on it are?

Personally I think it is a bad idea. At a cost of €300 million per year I'm not sure it represents value for money. While I am not opposed at all to giving medical cards to people who genuinely can't afford GP care, I think giving freebies to people who clearly can pay is almost always bad economics (one only has to look at the drain of child benefit to families who don't need it).

Also it is quite easy to envisage a future where there is a massive "clogging up" in primary care as people abuse their new free privilege, which will lead to a massively reduced quality of service. This will also have knock on effects for the entire health service.

Thoughts?

Link- http://www.irishtimes.com/newspaper/ireland/2011/1118/1224307766698.html

That idea will be binned.

Amirani

Good loser wrote: »

That idea will be binned.

Undoubtedly. And rightly so IMO.

Cedrus

It could be argued that if people are able to go to a GP regularly that long term illnesses, alcohol abuse, obesity etc can be detected and treated when they are minor before the patient becomes a major drain on the healthcare system thus saving money.

A public health professional commented to me a long time ago that Ireland doesn't have a Health System we have a Sick System. Apart from maternity/ Natal care the vast majority of the health budget is spent trying to mend damage that patients could have avoided if they had copped on to their lifestyle/diet/exercise/immunisations sooner. Preventative healthcare is a minor part of the budget philosophy.

gaffer91

Cedrus wrote: »

It could be argued that if people are able to go to a GP regularly that long term illnesses, alcohol abuse, obesity etc can be detected and treated when they are minor before the patient becomes a major drain on the healthcare system thus saving money.

A public health professional commented to me a long time ago that Ireland doesn't have a Health System we have a Sick System. Apart from maternity/ Natal care the vast majority of the health budget is spent trying to mend damage that patients could have avoided if they had copped on to their lifestyle/diet/exercise/immunisations sooner. Preventative healthcare is a minor part of the budget philosophy.

I don't think its the GP's primary responsibility to tell someone to stop smoking/eat healthier/exercise etc. While preventative care is indeed a part of their job, it really comes down to the person themself at the end of the day. Practically everyone nowadays is aware of the fact that smoking and eating in the chipper 5 nights a week etc. is extremely unhealthy and I don't see how much difference hearing it from a GP is realistically going to make.

I'd be more of the opinion that they'd be the kind of people who'd clog up primary care tbh.

Preventative care would have more to do with education in schools (which is happening in fairness), ad campaigns etc and less to do with GP's.

Dannyboy83

gaffer91 wrote: »

I don't think its the GP's primary responsibility to tell someone to stop smoking/eat healthier/exercise etc. While preventative care is indeed a part of their job, it really comes down to the person themself at the end of the day. Practically everyone nowadays is aware of the fact that smoking and eating in the chipper 5 nights a week etc. is extremely unhealthy and I don't see how much difference hearing it from a GP is realistically going to make.

Smoking is an obvious one, yes.
Diabetes - no.
Blood pressure/heart disease - no.
Various types of cancers - no.
There are a litany of less obvious conditions which are major killers.

Cancer screening in Ireland is non-existant for males.
Irish people are generally clueless about their diets, rarely educated on the topic.

Until we have some cancer screening systems & heart disease screening systems set up, it will continue to be a sick system.

gaffer91

Dannyboy83 wrote: »

Smoking is an obvious one, yes.
Diabetes - no.
Blood pressure/heart disease - no.

The risk factors for both diabetes and heart disease can be drastically reduced by eating fairly healthily, exercising and not smoking.

Dannyboy83 wrote: »

Various types of cancers - no.
There are a litany of less obvious conditions which are major killers.

Cancer screening in Ireland is non-existant for males.

Cancer screening could probably increase alright, and it is indeed practically non-existent for males. However as far as I'm aware apparently screening for the likes of prostate cancer is not actually that effective unfortunately.

Dannyboy83 wrote: »

Irish people are generally clueless about their diets, rarely educated on the topic.

I think most people would have a fair idea of what would constitute a relatively healthy diet in fairness. And even if you think Irish people are clueless, I think it shouldn't be down to GP's to enlighten the public about healthy eating- similarly to what I stated earlier, while they can say it to individual patients, I think ads on newspapers, TV etc. and going around to schools would be more effective.

ednwireland

primary preventative healthcare is probably the best way of catching illness early. early treatment saves money. charging 40 or 50 quid per visit puts people off seeking treatment early.

Godge

Cedrus wrote: »

It could be argued that if people are able to go to a GP regularly that long term illnesses, alcohol abuse, obesity etc can be detected and treated when they are minor before the patient becomes a major drain on the healthcare system thus saving money.

A public health professional commented to me a long time ago that Ireland doesn't have a Health System we have a Sick System. Apart from maternity/ Natal care the vast majority of the health budget is spent trying to mend damage that patients could have avoided if they had copped on to their lifestyle/diet/exercise/immunisations sooner. Preventative healthcare is a minor part of the budget philosophy.

I agree with this. Many people don't go to the doctor for an annual check-up as it costs money and they are not sick.

gaffer91

I'm not going to lie, some of the responses give me the impression that people are just delighted that the government is giving them another freebie.

OAP's have free access to GP's. Would people really argue that this a good thing for primary care? I'm sure most people would agree that it is a privilege that is very often abused and is detrimental to primary care as a whole.Now imagine extending this to the entire population, and the adverse consequences it would have, the time wasted, the unnecessary visits, the growing waiting lists, the costs to the state etc.

Primary Care should be free only for people who genuinely can't afford it and the long term ill.

Cedrus

gaffer91 wrote: »

I'm not going to lie, some of the responses give me the impression that people are just delighted that the government is giving them another freebie.

OAP's have free access to GP's. Would people really argue that this a good thing for primary care? I'm sure most people would agree that it is a privilege that is very often abused and is detrimental to primary care as a whole.Now imagine extending this to the entire population, and the adverse consequences it would have, the time wasted, the unnecessary visits, the growing waiting lists, the costs to the state etc.

Primary Care should be free only for people who genuinely can't afford it and the long term ill.

I think that GP access should be available to all but also think that the taxpayers shouldn't be paying for everybody, those who can pay should pay (even pensioners). I certainly don't think that malingerers getting sick notes should be covered.
However, an annual check-up (and any necessary follow-ups) should be a minimum right to nip problems in the bud. The problem with means testing, though necessary, is that people baulk at being asked about money . People also baulk at even thinking about lumps, embarrassing bits and being told that they're doing something wrong never mind doing something about it.

If I had the power to plan it I would propose a 3 stage health card
1. an free annual check up that is almost a legal obligation
2. GP and basic access for those who would struggle for a good median lifestyle
3. Full access for those who would struggle for the basics

I have a good healthy diet (low fat, no fried food, part time meat eater) but found out that I had high cholesterol when I went to the opticians!!

greendom

Biggest shock for me when I came over from England was having to pay for GP visits and having to pay full price for prescription drugs. Has there ever been a published study on the relative rates on illness on the 2 countries ?

I would imagine being able to see a GP without worrying about the cost would make you more likely to go and see one and would prevent a minor illness from becoming a major one.

MiissTL

Healthcare yes should be free.

It will never happen though.

I am a student and I can't pay €50 every time I need to go to the doctor. I went to the college doctor once and he pawned me off on a trainee who thought that I was a pin cushion. She was "trying" to do my bloods. I think 5 times she had to try. Destroyed my arms in bruises. College students are treated like Guinea Pigs. Also they sent my results to my doctor who I then had to go see to get them. I mean, come on! Totally defeated the purpose.

And I know on boards that students are considered a drain on society so to let you know - I don't drink, smoke or have a baby!

bmaxi

Why would it necessarily follow that free access to GPs would result in crammed surgeries? In my experience even those with free access only go when necessary and some only go on the insistence of the GP.
I have a long term condition which is controlled by drugs and I will have to go to my GP next week. I haven't been since June but he will not renew my prescriptions unless I see him every six months. That's fair enough, I know GPs worry about litigation but I feel alright and probably wouldn't go if that restriction was not in place.
The concern seems to be that people will go just to get sick notes and for the general purpose of malingering but any GP worth his salt will see through that very quickly, particularly if the offenders are imposing an excessive workload on his practice.
I would draw the line at free GP care for all though, those who can afford to pay should pay and I'd suspect those who can currently afford to pay, will be much more likely to go at the first sign of problems.

professore

I think free GP care would save the country money if done right. Lots of people don't visit the GP now unless they really have to, even supposedly "well off" people, since it is so expensive. You are lucky if a GP visit costs you less than € 100 between the fee and prescription, and/or bloods.

Then people put it off until such time as they are really sick, where they end up in A & E, and possibly a hospital stay. These are mostly productive members of society, so the economy also lose their economic contribution during this time.

Also spotting the risk of expensive underlying conditions earlier like diabetes, heart disease etc, would prevent many people getting these conditions in the first place - these cost huge sums of money to the exchequer.

Also, allowing qualified GPs to set up their own practises and not tying the patient to a specific practise - i.e. money follows the patient - would bring costs down.

Finally, people would pay extra for a comprehensive health service, especially if they could ditch health insurance. I know someone working in training of GPs and he holds similar views, and many GPs agree with him.

brian ireland

I don't think it should be free. A small charge must apply. A friend of mine lives in a country with free GP Care, only recently they introduced a small charge because some people where just going to the GP for a chat.